Community Attitudes Toward Mass Drug Administration for Control and Elimination of Neglected Tropical Diseases After the 2014 Outbreak of Ebola Virus Disease in Lofa County, Liberia

Abstract

The recent outbreak of Ebola virus disease (EVD) interrupted mass drug administration (MDA) programs to control and eliminate neglected tropical diseases in Liberia. MDA programs treat entire communities with medication regardless of infection status to interrupt transmission and eliminate lymphatic filariasis and onchocerciasis. Following reports of hostilities toward health workers and fear that they might be spreading EVD, it was important to determine whether attitudes toward MDA might have changed after the outbreak. We surveyed 140 community leaders from 32 villages in Lofa County, Liberia, that had previously participated in MDA and are located in an area that was an early epicenter of the EVD outbreak. Survey respondents reported a high degree of community trust in the MDA program, and 97% thought their communities were ready to resume MDA. However, respondents predicted that fewer people would comply with MDA after the EVD epidemic than before. The survey also uncovered fears in the community that EVD and MDA might be linked. Respondents suggested that MDA programs emphasize to people that the medications are identical to those previously distributed and that MDA programs have nothing to do with EVD.

Onchodermatitis: Where Are We Now?

“…Non-compliance with treatment has been another issue is some areas [ 95 ] but can be improved using traditional kinship structures [ 96 ]. Hostility towards health workers occurred during the Ebola outbreak as some people feared they were responsible for spreading Ebola [ 97 ].…”

The changing global landscape of health and disease: addressing challenges and opportunities for sustaining progress towards control and elimination of neglected tropical diseases (NTDs)

“…Liberia where successes in onchocerciasis control has led to the emergence of NTD programmes supported initially by Non-Governmental Development Organizations (NGDOs) (Bogus et al 2016;Thomas et al 2017). Thus, global and national shocks frequently become a significant disrupting factor for NTD control, and create a challenge for the ability of health systems to respond appropriately to changing population needs, whilst also supporting the 'everyday resilience' that allows for the ongoing functioning of routine activity, such as immunization and NTD programme delivery (Gilson et al 2017).…”

Community-Based Surveillance to Monitor Mortality in a Malaria-Endemic and Ebola-Epidemic Setting in Rural Guinea

“…The number of sEVD deaths increased from period 1 to 6; however, the difference in period-specific estimates was not significant (P = 0.132). EVD suspect proportional mortality increased by 6.1% (95% CI = 1.3-10.8, P = 0.011) from period 1 to period 6, while exhibiting fluctuations probably due to the small number of sEVD deaths per period (range [6][7][8][9][10][11][12][13][14][15][16][17]. The largest number of EVD suspect deaths was reported during period 6 and coincided with the apparition of EVD in Guéckédou.…”

“…6,7 Although the majority of health facilities remained open during the epidemic, health-care workers were infected and there was fear of EVD in the community. 8 Consequently, patients stayed away from health facilities 9 decreasing the reliability of data collected in health facilities during this period. Diagnosis of malaria infections was further complicated during the epidemic due to the overlap of malaria and EVD symptoms 10 ; malaria testing was suspended during the EVD epidemic unless the health-care workers had and used appropriate personal protective equipment.…”